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General NPI Number Information
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NPI Number | 1538011945
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Entity Type | Individual
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Provider Name | REAGAN ELIZABETH BOURGEOIS RN
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Gender | Female
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Dates
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Enumeration Date | 02/10/2026
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 711 DR MICHAEL DEBAKEY DR
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City | LAKE CHARLES
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State | LA
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Zip | 70601-5785
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Country | US
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Telephone | 337-419-1958
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Fax |
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Provider Business Mailing Address
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Address Line | 3082 LYONS RD
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City | LAKE ARTHUR
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State | LA
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Zip | 70549-5233
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Country | US
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Telephone | 337-529-0335
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 206803
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License Number State | LA
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